Novel targeted therapies and vaccination strategies for mesothelioma

Our plain-English summary of Novel targeted therapies and vaccination strategies for mesothelioma, by M. Bagia, A.K. Nowak (Current Treatment Options in Oncology, 2011).

The study

• Authors: M. Bagia, A.K. Nowak
• Journal: Current Treatment Options in Oncology
• Published: 2011;12(2):149-62
• Type of article: Review
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Novel targeted therapies have found a niche in the treatment of many cancers, although the most responsive populations, best biomarkers of response, and appropriate treatment settings are still under investigation. With few exceptions, cancer vaccination strategies have not entered into routine management. In malignant mesothelioma, combination first-line chemotherapy with a platinum and pemetrexed remains the standard of care when systemic therapy is considered. Second-line chemotherapy is used but benefits are uncertain in the absence of appropriately controlled randomized trials. Currently, there are no novel targeted therapies or vaccinations that should be used in this disease outside the context of a clinical trial.

In plain English

This article was a review, not an original study. The authors set out to update readers on recent developments in novel targeted drugs and vaccination strategies for malignant mesothelioma, focusing on research that had reached clinical trials. Surgery, chemotherapy trends and asbestos exposure were not discussed. The authors stated that use of bevacizumab was not recommended until mature results were available, that trials of erlotinib and gefitinib had been disappointing, and that three earlier imatinib studies were clearly negative. Overall, they wrote that most studies had been negative. They described small vaccine studies. In one, three of ten patients given a dendritic cell vaccine had a partial response; all had received chemotherapy beforehand, and the authors noted these might still be late responses to chemotherapy, though they thought this less likely. In another, seven of 22 patients developed immune responses but none had an objective tumor response. A WT-1 peptide vaccine produced no objective responses among nine patients with mesothelioma. The authors concluded that, in 2011, standard systemic treatment remained a platinum drug plus pemetrexed, and that no novel targeted therapy or vaccination should be used outside a clinical trial.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of novel targeted therapies and vaccination strategies for malignant mesothelioma
• Who was studied: No study population of its own. The review covered published, presented and ongoing clinical trials, plus laboratory and animal studies, of new treatments for malignant mesothelioma
• Exposure: Not applicable: the review concerns treatments (targeted drugs, immunotherapies and vaccines), not asbestos or other exposures
• Main results:
  • The authors stated that bevacizumab should not be used in mesothelioma until mature trial results are available
  • Trials of the EGFR inhibitors erlotinib and gefitinib in mesothelioma were described as disappointing
  • Three earlier studies of imatinib were described as clearly negative
  • In a cited study, ten patients with mesothelioma received autologous dendritic cells pulsed with tumor lysate, and three had a partial response
  • All ten patients in that dendritic cell study had received chemotherapy before the vaccine. The authors noted the responses might still be late responses to chemotherapy, though they judged this less likely
  • In a cited study of autologous tumor lysate with GM-CSF in 22 patients with mesothelioma, 7 of 22 developed immune responses, but there were no objective tumor responses
  • In a cited WT-1 peptide vaccine trial, eight of nine patients with mesothelioma progressed within 6 months and no objective responses were reported
  • Overall, the authors judged that most studies of targeted agents in mesothelioma had been negative
• The authors' conclusion: The authors concluded that no novel targeted therapies or vaccinations should be used in mesothelioma outside a clinical trial, and that in 2011 evidence-based systemic treatment remained a platinum drug combined with pemetrexed
• Limitations the authors state:
  • The review did not address surgical management or chemotherapy trends
  • Some other molecular pathways under investigation were left outside the review's scope

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Biomarker, Chemotherapy, Pemetrexed (Alimta), Systemic Therapy, Clinical Trial.

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• Fowlpox-based survivin vaccination for malignant mesothelioma therapy — P. Bertino, M. Panigada, et al. (2013)
• Latest developments in our understanding of the pathogenesis of mesothelioma and the design of targeted therapies — A. Bononi, A. Napolitano, et al. (2015)
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• Novel therapies for malignant pleural mesothelioma — A. Scherpereel, F. Wallyn, et al. (2018)

Browse more research in Current Treatment Options in Oncology, or return to medical research.